Provider Demographics
NPI:1346800182
Name:IBRAHIM, SHERIF
Entity Type:Individual
Prefix:MR
First Name:SHERIF
Middle Name:
Last Name:IBRAHIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3180
Mailing Address - Country:US
Mailing Address - Phone:857-241-0576
Mailing Address - Fax:
Practice Address - Street 1:150 BEAR HILL ROAD
Practice Address - Street 2:ONCO360 ONCOLOGY PHARMACY
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-0245
Practice Address - Country:US
Practice Address - Phone:877-662-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2351801835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology